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Davangere - The Oxford of India
Bapuji Educational Association
Council Members
BEA - Institutions
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Contact Info
For Admissions Contact

Tel. Off. 08192 – 266301 & 02, 08192-261807

-Fax. 91-8192-266310

Mob. 9901166668 

E-mail : ssimsrc@rediffmail.com
E-mail : beasec@sancharnet.in
Name Of Applicant*
Father's Name*
Mother's Name*
Address for Correspondence*
State*
City*
Pin-code*
Telephone* With STD code
Mobile
Email*
Permanent Address *
State*
City*
Pin-code*
Address for Correspondence in India (For NRIs)
State
City
Pin-code
Date Of Birth*
Place of Birth*
Nationality*
Passport No. & Validity (Incase of NRI)
Visa No. & Validity (Incase of NRI)
Sex*
Religion*
Whether Belong to Scheduled Caste / Scheduled Tribe
If Yes, Pls. specify, else enter No
Previous Education Details
Name & Address of the Previous Institution last studied*
Name of Board / University *
Marks Obtained in +2 Course*
PhysicsChemistryBiologyEnglish
Aggregate Percentage of Marks in Physics, Chemistry & Biology in +2 Course*
Declaration By the Candidate
I hereby declare that the information given above is true and correct and I further declare that I shall abide the rules and regulations of the College and the University.
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For more information, mail us at: admissions@ssimsrc.com

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